Thompson J F, Hibberd A D, Mohacsi P J, Chapman J R, MacDonald G J, Mahony J F
Royal Prince Alfred Hospital, Camperdown, N.S.W.
Anaesth Intensive Care. 1995 Feb;23(1):99-103. doi: 10.1177/0310057X9502300117.
There are many reasons why potential cadaveric organ donors may fail to become actual donors. These include permission refusal by the next of kin, incorrect assumptions about medical suitability and, occasionally, an excessive workload in the intensive care unit. Some potential donors currently regarded in Australia as "unrealistic" might become actual donors if attitudes were to change towards ventilation of patients with a clearly hopeless prognosis who have expressed a wish to be organ donors. "Required request" legislation ignores the wishes of the potential donor and "presumed consent" laws also present some ethical difficulties, but a suggested "required response" process could ensure that an individual's wishes concerning organ donation would be known and able to be carried out after death. For the present, however, it is clear that operating within existing Australian legislation and abiding by currently accepted codes of practice, we can still find considerable scope for improving cadaveric organ donation rates.
潜在的尸体器官捐赠者未能成为实际捐赠者的原因有很多。这些原因包括近亲拒绝许可、对医学适用性的错误假设，以及偶尔出现的重症监护病房工作量过大。如果对那些预后明显无望但表示希望成为器官捐赠者的患者进行通气的态度能够改变，那么目前在澳大利亚被视为“不切实际”的一些潜在捐赠者可能会成为实际捐赠者。“强制要求”立法忽视了潜在捐赠者的意愿，“推定同意”法律也存在一些伦理难题，但建议的“强制回应”程序可以确保一个人关于器官捐赠的意愿在死后能够被知晓并得以执行。然而，就目前而言，很明显，在澳大利亚现行法律框架内运作并遵守目前公认的行为准则，我们仍能找到大幅提高尸体器官捐赠率的空间。
